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General NPI Number Information
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NPI Number | 1972626968
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4964 WOODWARD GDNS
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City | COLUMBIA
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State | MD
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Zip | 21044-1525
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Country | US
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Telephone | 410-740-1750
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Fax | 410-740-4330
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Provider Business Mailing Address
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Address Line | 4964 WOODWARD GDNS
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City | COLUMBIA
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State | MD
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Zip | 21044-1525
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Country | US
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Telephone | 410-740-1750
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Fax | 410-740-4330
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SANDRA RUTH JOHNSON
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Credential | LIC.AC.
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Telephone | 410-740-1750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U00736
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License Number State | MD
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